Hemodialysis-related upper cervical extradural amyloidoma presenting with intractable radiculopathy

Eur Spine J. 2012 Jun;21 Suppl 4(Suppl 4):S463-6. doi: 10.1007/s00586-011-2084-z. Epub 2011 Nov 25.


Introduction: Destructive spondyloarthropathy may occur in long-term hemodialysis patients, but focal amyloid deposits in the spine are rare. We present a case of upper cervical extradural amyloidoma with a history of long-term hemodialysis presenting with progressive and intractable radiculopathy.

Clinical presentation: We describe a 51-year-old female with a long-term history of hemodialysis treatment. She suffered progressive and intolerable right occipital headache. Neurological examination revealed right C2 radiculopathy. Magnetic resonance imaging (MRI) of the cervical spine showed a solid focal extradural mass lesion at the C2 level. She underwent subtotal resection of the extradural mass lesion and decompression of the right C2 nerve root by a posterior approach. Histological examination revealed amyloid deposits. The occipital headache immediately disappeared after surgery. Follow-up MRI 10 months after surgery demonstrated no recurrence of the extradural amyloidoma.

Conclusion: Development of an upper cervical extradural amyloidoma after long-term hemodialysis is extremely rare. Prompt evaluation of long-term hemodialysis patients suffering from progressive cervical pain should be recommended, and treatment is required if there are signs or symptoms of compression of a nerve root or the spinal cord.

Publication types

  • Case Reports

MeSH terms

  • Amyloidosis / etiology*
  • Amyloidosis / pathology
  • Amyloidosis / surgery
  • Cervical Vertebrae / pathology*
  • Cervical Vertebrae / surgery
  • Female
  • Humans
  • Middle Aged
  • Plaque, Amyloid / etiology*
  • Plaque, Amyloid / pathology
  • Plaque, Amyloid / surgery
  • Radiculopathy / etiology*
  • Radiculopathy / pathology
  • Radiculopathy / surgery
  • Renal Dialysis / adverse effects*
  • Renal Insufficiency, Chronic / therapy
  • Treatment Outcome